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2. About the Form
   Submit this form for CCL and Hankin programs which require a room setup in the Struble Room, Hankin Community Room, or Annex. The form should be submitted at least 7 days in advance of program date. The form will be submitted to Bruce Brown. Thank you for your cooperation.
4. Meeting Room Location

   1. Struble Room (CCL)
   2. Hankin Community Room
   3. Hankin Annex
6. Program Title*
8. Program Date & Time*
   Program Date & Time Start Date

   Program Date & Time Start Time

   —

   Program Date & Time End Date

   Program Date & Time End Time
10. Staff Person Name*
11. Staff Person Phone Number*
13. Staff Person Email Address*
15. Outside Contact Name*
16. Outside Contact Phone Number*
18. Number of Attendees*
19. Number of Chairs*
20. Number of Tables*
22. Type of Set-Up
    -- Select One --ClassroomConferenceHollow SquareTheaterU-Shape
23. 
25. Other Instructions*
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field